tbuckley/cabot-search huggingface dataset:
Primary Care Physicians: The Bialystok Horses of Health Care?
Authors: Eleanor R. Menzin
Journal: Annals of Internal Medicine (2023)

On Being a DoctorAugust 2023Primary Care Physicians: The Bialystok Horses of Health Care?Eleanor R. Menzin, MDEleanor R. Menzin, MDBoston Children’s Hospital, Harvard Medical School, and Longwood Pediatrics, Boston, MassachusettsSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-1353 Audio Reading - “Primary Care Physicians: The Bialystok Horses of Health Care?” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Primary Care Physicians: The Bialystok Horses of Health Care?” by Eleanor R. Menzin, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I grew up hearing my family’s version of a Yiddish folk tale about a Bialystok horse. To summarize, a peasant has a reliable horse he uses to bring passengers to and from the city of Bialystok. One day, to maximize profits and efficiency, he decides to feed the horse less and less food and water. Initially, he is wildly successful and thrilled with his miracle horse. One does not need to be a veterinarian to see how it ends: The horse grows weaker and dies. As a primary care doctor, I fear I am a Bialystok horse.Twenty-odd years ago ... Author, Article, and Disclosure InformationAuthors: Eleanor R. Menzin, MDAffiliations: Boston Children’s Hospital, Harvard Medical School, and Longwood Pediatrics, Boston, MassachusettsCorresponding Author: Eleanor R. Menzin, MD, 319 Longwood Avenue, Boston, MA 02115; e-mail, Eleanor.menzin@childrens.harvard.edu. PreviousarticleNextarticle Advertisement Audio Reading - “Primary Care Physicians: The Bialystok Horses of Health Care?” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Primary Care Physicians: The Bialystok Horses of Health Care?” by Eleanor R. Menzin, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics Current IssueAugust 2023Volume 176, Issue 8Page: 1135 ePublished: 15 August 2023 Issue Published: August 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Chronic thromboembolic pulmonary hypertension: realising the potential of multimodal management
Authors: Marion Delcroix, Marc de Perrot, Xavier Jaïs, David P Jenkins, Irene M Lang, Hiromi Matsubara, Lilian J Meijboom, Rozenn Quarck, Gérald Simonneau, Christoph B Wiedenroth, Nick H Kim
Journal: The Lancet Respiratory Medicine (2023)
Obstetric and neonatal outcomes in pregnant women with and without a history of specialist mental health care: a national population-based cohort study using linked routinely collected data in England
Authors: Julia Langham, Ipek Gurol-Urganci, Patrick Muller, Kirstin Webster, Emma Tassie, Margaret Heslin, Sarah Byford, Asma Khalil, Tina Harris, Helen Sharp, Dharmintra Pasupathy, Jan van der Meulen, Louise M Howard, Heather A O'Mahen
Journal: The Lancet Psychiatry (2023)

Pregnant women with pre-existing mental illnesses have increased risks of adverse obstetric and neonatal outcomes compared with pregnant women without pre-existing mental illnesses. We aimed to estimate these differences in risks according to the highest level of pre-pregnancy specialist mental health care, defined as psychiatric hospital admission, crisis resolution team (CRT) contact, or specialist community care only, and the timing of the most recent care episode in the 7 years before pregnancy. Hospital and birth registration records of women with singleton births between April 1, 2014, and March 31, 2018 in England were linked to records of babies and records from specialist mental health services provided by the England National Health Service, a publicly funded health-care system. We compared the risks of adverse pregnancy outcomes, including fetal and neonatal death, preterm birth, and babies being born small for gestational age (SGA; birthweight <10th percentile), and composite indicators for neonatal adverse outcomes and maternal morbidity, between women with and without a history of contact with specialist mental health care. We calculated odds ratios adjusted for maternal characteristics (aORs), using logistic regression. Of 2 081 043 included women (mean age 30·0 years; range 18-55 years; 77·7% White, 11·4% South Asian, 4·7% Black, and 6·2% mixed or other ethnic background), 151 770 (7·3%) had at least one pre-pregnancy specialist mental health-care contact. 7247 (0·3%) had been admitted to a psychiatric hospital, 29 770 (1·4%) had CRT contact, and 114 753 (5·5%) had community care only. With a pre-pregnancy mental health-care contact, risk of stillbirth or neonatal death within 7 days of birth was not significantly increased (0·45-0·49%; aOR 1·11, 95% CI 0·99-1·24): risk of preterm birth (<37 weeks) increased (6·5-9·8%; aOR 1·53, 1·35-1·73), as did risk of SGA (6·2- 7·5%; aOR 1·34, 1·30-1·37) and neonatal adverse outcomes (6·4-8·4%; aOR 1·37, 1·21-1·55). With a pre-pregnancy mental health-care contact, risk of maternal morbidity increased slightly from 0·9% to 1·0% (aOR 1·18, 1·12-1·25). Overall, risks were highest for women who had a psychiatric hospital admission any time or a mental health-care contact in the year before pregnancy. Information about the level and timing of pre-pregnancy specialist mental health-care contacts helps to identify women at increased risk of adverse obstetric and neonatal outcomes. These women are most likely to benefit from dedicated community perinatal mental health teams working closely with maternity services to provide integrated care. National Institute for Health Research.
The Complete Blood Count: Increasing Its Precision and Impact
Authors: W. Richard Burack, Marshall A. Lichtman
Journal: Annals of Internal Medicine (2023)

LettersAugust 2023The Complete Blood Count: Increasing Its Precision and ImpactW. Richard Burack, MD, PhD, and Marshall A. Lichtman, MDW. Richard Burack, MD, PhDDepartment of Pathology and Laboratory Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, and Marshall A. Lichtman, MDDepartment of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New YorkAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L23-0165 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We appreciate these considered responses, which echo concerns that we have heard previously when presenting this proposal. Reimagining the CBC is important because most CBCs are ordered as a "screening test." However, the training we have received focused on its relatively infrequent—albeit vital—use as a "diagnostic test" for hematologic abnormalities, most often anemia.For example, Drs. Lucijanic and Krecak raise concerns about not reporting components of the CBC that may be useful in highly specific contexts. They also mention several ill-advised referrals to a hematologist because the primary provider misinterpreted redundant or less impactful components of the CBC. ... Author, Article, and Disclosure InformationAuthors: W. Richard Burack, MD, PhD; Marshall A. Lichtman, MDAffiliations: Department of Pathology and Laboratory Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New YorkDepartment of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New YorkDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-3071. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Complete Blood Count: Increasing Its Precision and Impact W. Richard Burack and Marshall A. Lichtman The Complete Blood Count: Increasing Its Precision and Impact Marko Lucijanic , and Ivan Krecak The Complete Blood Count: Increasing Its Precision and Impact Stephen D. Sisson Metrics August 2023Volume 176, Issue 8KeywordsAnemiaComplete blood countHematocritIron deficiencyMean corpuscular hemoglobinMean corpuscular hemoglobin concentrationMean corpuscular volumeRed blood cellsReticulocytesWhite blood cells ePublished: 15 August 2023 Issue Published: August 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Annals On Call - Medical Marijuana
Authors: Robert M. Centor, Davis N. Bradford
Journal: Annals of Internal Medicine (2023)

Web ExclusivesAugust 2023Annals On Call - Medical MarijuanaFREERobert M. Centor, MD, and Davis N. Bradford, MDRobert M. Centor, MDHuntsville Regional Medical Campus, University of Alabama Birmingham School of Medicine, Birmingham, Alabama (R.M.C.)Search for more papers by this author, and Davis N. Bradford, MDUniversity of Alabama Birmingham School of Medicine, Birmingham, Alabama (D.N.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/A22-0016 CME/MOC SectionsAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this episode of Annals On Call, Dr. Centor discusses medical marijuana with Dr. Davis Bradford.Annals articles discussed include...Cannabis-Based Products for Chronic Pain. A Systematic Review: https://www.acpjournals.org/doi/10.7326/M21-4520Reconciling the Discrepancies in Medicine's Relationship to Medical Marijuana: https://www.acpjournals.org/doi/10.7326/M18-1883About Annals On CallAnnals On Call focuses on a clinically influential article published in Annals of Internal Medicine. Dr. Robert Centor shares his own perspective on the material and interviews topic area experts to discuss, debate, and share diverse insights about patient care and health care delivery.For more information on Annals On Call and for more episodes, visit go.annals.org/OnCall. Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAuthors: Robert M. Centor, MD; Davis N. Bradford, MDAffiliations: Huntsville Regional Medical Campus, University of Alabama Birmingham School of Medicine, Birmingham, Alabama (R.M.C.)University of Alabama Birmingham School of Medicine, Birmingham, Alabama (D.N.B.)Disclosures: All relevant financial relationships have been mitigated. Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=A22-0016.Editors' Disclosures: The editors have no relevant financial relationships to disclose. Individual forms may be viewed at www.annals.org/editorsdisclosures. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoReconciling the Discrepancies in Medicine's Relationship to Medical Marijuana Ilana Braun and James Tulsky Cannabis-Based Products for Chronic Pain Marian S. McDonagh , Benjamin J. Morasco , Jesse Wagner , Azrah Y. Ahmed , Rongwei Fu , Devan Kansagara , and Roger Chou Metrics August 2023Volume 176, Issue 8 ePublished: 15 August 2023 Issue Published: August 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.Loading ...
Omicron neutralisation: RBD-dimer booster versus BF.7 and BA.5.2 breakthrough infection
Authors: Lianpan Dai, Huixin Duan, Xueyuan Liu, Huan Zhou, Minrun Duan, Yaling An, Linfeng Yuan, Xin Zhao, Kun Xu, Qiang Wu, George F Gao
Journal: The Lancet (2023)
Incidence and risk factors of tuberculosis among 420 854 household contacts of patients with tuberculosis in the 100 Million Brazilian Cohort (2004–18): a cohort study
Authors: Priscila F P S Pinto, Camila S S Teixeira, Maria Yury Ichihara, Davide Rasella, Joilda S Nery, Samila O L Sena, Elizabeth B Brickley, Maurício L Barreto, Mauro N Sanchez, Julia M Pescarini
Journal: The Lancet Infectious Diseases (2023)

BackgroundAlthough household contacts of patients with tuberculosis are known to be particularly vulnerable to tuberculosis, the published evidence focused on this group at high risk within the low-income and middle-income country context remains sparse. Using nationwide data from Brazil, we aimed to estimate the incidence and investigate the socioeconomic and clinical determinants of tuberculosis in a cohort of contacts of tuberculosis patients.MethodsIn this cohort study, we linked individual socioeconomic and demographic data from the 100 Million Brazilian Cohort to mortality data and tuberculosis registries, identified contacts of tuberculosis index patients diagnosed from Jan 1, 2004 to Dec 31, 2018, and followed up the contacts until the contact's subsequent tuberculosis diagnosis, the contact's death, or Dec 31, 2018. We investigated factors associated with active tuberculosis using multilevel Poisson regressions, allowing for municipality-level and household-level random effects.FindingsWe studied 420 854 household contacts of 137 131 tuberculosis index patients. During the 15 years of follow-up (median 4·4 years [IQR 1·9–7·6]), we detected 8953 contacts with tuberculosis. The tuberculosis incidence among contacts was 427·8 per 100 000 person-years at risk (95% CI 419·1–436·8), 16-times higher than the incidence in the general population (26·2 [26·1–26·3]) and the risk was prolonged. Tuberculosis incidence was associated with the index patient being preschool aged (<5 years; adjusted risk ratio 4·15 [95% CI 3·26–5·28]) or having pulmonary tuberculosis (2·84 [2·55–3·17]).InterpretationThe high and sustained risk of tuberculosis among contacts reinforces the need to systematically expand and strengthen contact tracing and preventive treatment policies in Brazil in order to achieve national and international targets for tuberculosis elimination.FundingWellcome Trust and Brazilian Ministry of Health.
Here I Sit Me Down to Die
Authors: Maryella Desak Sirmon
Journal: Annals of Internal Medicine (2023)

Ad LibitumAugust 2023Here I Sit Me Down to DieMaryella Desak Sirmon, MDMaryella Desak Sirmon, MDUniversity of South Alabama Mobile, AlabamaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-3069 Audio Reading - “Here I Sit Me Down to Die” Audio. Virginia L. Hood, MD, a physician from the University of Vermont, reads “Here I Sit Me Down to Die” by Maryella Desak Sirmon, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Here I sit me down to die,above the mountainbeneath the sky,an inconvenience by and by to you who must with solemn effort haul my dust.Forgive me friends, my demise.Your faces masked,yet pregnant eyesbetray each face's stoic guise. For there I see embarrassed tears you hide for me.The adverbs right, how and where,Gods may be justthough death not fair.Life is life for all its care. When is never answered now by those who hope if Fates allow.So grieve, rejoice, remember me.I was, I am,I yet shall be—unfettered spirit, finally free, my soul in prayer forever kept, as down I lay neath stars and slept. Author, Article, and Disclosure InformationAuthors: Maryella Desak Sirmon, MDAffiliations: University of South Alabama Mobile, AlabamaCorresponding Author: Maryella Desak Sirmon, MD; e-mail, mdsirmon@aol.com. PreviousarticleNextarticle Advertisement Audio Reading - “Here I Sit Me Down to Die” Audio. Virginia L. Hood, MD, a physician from the University of Vermont, reads “Here I Sit Me Down to Die” by Maryella Desak Sirmon, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics Current IssueAugust 2023Volume 176, Issue 8Page: 1136 ePublished: 15 August 2023 Issue Published: August 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Gaussian Process-based prediction of memory performance and biomarker status in ageing and Alzheimer’s disease—A systematic model evaluation
Authors: A. Nemali, N. Vockert, D. Berron, A. Maas, J. Bernal, R. Yakupov, O. Peters, D. Gref, N. Cosma, L. Preis, J. Priller, E. Spruth, S. Altenstein, A. Lohse, K. Fliessbach, O. Kimmich, I. Vogt, J. Wiltfang, N. Hansen, C. Bartels, B.H. Schott, F. Maier, D. Meiberth, W. Glanz, E. Incesoy, M. Butryn, K. Buerger, D. Janowitz, R. Pernecky, B. Rauchmann, L. Burow, S. Teipel, I. Kilimann, D. Göerß, M. Dyrba, C. Laske, M. Munk, C. Sanzenbacher, S. Müller, A. Spottke, N. Roy, M. Heneka, F. Brosseron, S. Roeske, L. Dobisch, A. Ramirez, M. Ewers, P. Dechent, K. Scheffler, L. Kleineidam, S. Wolfsgruber, M. Wagner, F. Jessen, E. Duzel, G. Ziegler
Journal: Medical Image Analysis (2023)

Neuroimaging markers based on Magnetic Resonance Imaging (MRI) combined with various other measures (such as genetic covariates, biomarkers, vascular risk factors, neuropsychological tests etc.) might provide useful predictions of clinical outcomes during the progression towards Alzheimer's disease (AD). The use of multiple features in predictive frameworks for clinical outcomes has become increasingly prevalent in AD research. However, many studies do not focus on systematically and accurately evaluating combinations of multiple input features. Hence, the aim of the present work is to explore and assess optimal combinations of various features for MR-based prediction of (1) cognitive status and (2) biomarker positivity with a multi-kernel learning Gaussian process framework. The explored features and parameters included (A) combinations of brain tissues, modulation, smoothing, and image resolution; (B) incorporating demographics & clinical covariates; (C) the impact of the size of the training data set; (D) the influence of dimensionality reduction and the choice of kernel types. The approach was tested in a large German cohort including 959 subjects from the multicentric longitudinal study of cognitive impairment and dementia (DELCODE). Our evaluation suggests the best prediction of memory performance was obtained for a combination of neuroimaging markers, demographics, genetic information (ApoE4) and CSF biomarkers explaining 57% of outcome variance in out-of-sample predictions. The highest performance for Aβ42/40 status classification was achieved for a combination of demographics, ApoE4, and a memory score while usage of structural MRI further improved the classification of individual patient's pTau status.
Tubular lysosome induction couples animal starvation to healthy aging
Authors: Tatiana V. Villalobos, Bhaswati Ghosh, Kathryn R. DeLeo, Sanaa Alam, Cristian Ricaurte-Perez, Andrew Wang, Brennan M. Mercola, Tyler J. Butsch, Cara D. Ramos, Suman Das, Eric D. Eymard, K. Adam Bohnert, Alyssa E. Johnson
Journal: Nature Aging (2023)

Dietary restriction promotes longevity in several species via autophagy activation. However, changes to lysosomes underlying this effect remain unclear. Here using the nematode Caenorhabditis elegans, we show that the induction of autophagic tubular lysosomes (TLs), which occurs upon dietary restriction or mechanistic target of rapamycin inhibition, is a critical event linking reduced food intake to lifespan extension. We find that starvation induces TLs not only in affected individuals but also in well-fed descendants, and the presence of gut TLs in well-fed progeny is predictive of enhanced lifespan. Furthermore, we demonstrate that expression of Drosophila small VCP-interacting protein, a TL activator in flies, artificially induces TLs in well-fed worms and improves C. elegans health in old age. These findings identify TLs as a new class of lysosomes that couples starvation to healthy aging.
Regional, circuit and network heterogeneity of brain abnormalities in psychiatric disorders
Authors: Ashlea Segal, Linden Parkes, Kevin Aquino, Seyed Mostafa Kia, Thomas Wolfers, Barbara Franke, Martine Hoogman, Christian F. Beckmann, Lars T. Westlye, Ole A. Andreassen, Andrew Zalesky, Ben J. Harrison, Christopher G. Davey, Carles Soriano-Mas, Narcís Cardoner, Jeggan Tiego, Murat Yücel, Leah Braganza, Chao Suo, Michael Berk, Sue Cotton, Mark A. Bellgrove, Andre F. Marquand, Alex Fornito
Journal: Nature Neuroscience (2023)

The substantial individual heterogeneity that characterizes people with mental illness is often ignored by classical case-control research, which relies on group mean comparisons. Here we present a comprehensive, multiscale characterization of the heterogeneity of gray matter volume (GMV) differences in 1,294 cases diagnosed with one of six conditions (attention-deficit/hyperactivity disorder, autism spectrum disorder, bipolar disorder, depression, obsessive-compulsive disorder and schizophrenia) and 1,465 matched controls. Normative models indicated that person-specific deviations from population expectations for regional GMV were highly heterogeneous, affecting the same area in <7% of people with the same diagnosis. However, these deviations were embedded within common functional circuits and networks in up to 56% of cases. The salience-ventral attention system was implicated transdiagnostically, with other systems selectively involved in depression, bipolar disorder, schizophrenia and attention-deficit/hyperactivity disorder. Phenotypic differences between cases assigned the same diagnosis may thus arise from the heterogeneous localization of specific regional deviations, whereas phenotypic similarities may be attributable to the dysfunction of common functional circuits and networks.